Benefits through

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1 Benefits through

2 Saint Francis High School Benefits Benefits Overview: Eligibility Medical/Health Reimbursement Arrangement Kaiser or UHC Dental Vision Flexible Spending Accounts (Health Care & Dependent Care) Commuter Benefits Life/AD&D and Disability Insurance (STD / LTD) Employee Assistance Program / Travel Assistance Time Away from Work 403(b) Paycheck 2

3 Eligibility Full Time Employees Teach at least 4 classes or work at least 30 hours per week Part Time Employees Teach at least 3 classes or work at least 20 hours per week, Benefits Pro-Rated Dependents Your spouse Your children up to age 26 Your children include:» Your biological Children» Your adopted Children» Your stepchildren 3

4 Medical Coverage HMO/HRA Provider: Kaiser Permanente HMO (Health Maintenance Organization)/HRA (Health Reimbursement Arrangement) Plan year: January 1 to December 31 Calendar year deductible: January 1 to December 31 Group number Deductible Team

5 How an HRA works at Kaiser Action Required for Reimbursement Pay by cash, check, credit card, or debit card at check-in Print finalized claim and submit to Pension Dynamics via online submission, , fax or mail A reimbursement check will be sent to you in the mail in a few days or you can set up Direct Deposit * Deadline to submit HRA claims is March 31 for the previous calendar year. 5

6 Medical Coverage Kaiser HMO/HRA Health Reimbursement Arrangement Kaiser HMO/HRA Employee Only Family Annual Deductible $1,500 $3,000* (Calendar Year) Annual Out of Pocket Maximum $3,000 $6,000 (Including the Deductibles) SFHS (HRA) (Calendar Year) $1,500 $3,000 Maximum Out of Pocket Exposure to Employee $1,500 $3,000 Note: Well-Baby and Preventive Care covered at 100% (not subject to deductible) *The Deductible for any one Member in a Family of two or more Members is $1,500 per calendar year. 6

7 Medical Coverage Kaiser HMO/HRA Health Reimbursement Arrangement Kaiser HMO/HRA Employee Only Family Annual Deductible (Calendar Year) $1,500 $3,000 SFHS (HRA) (Calendar Year) $1,500 $3,000 Employee Out of Pocket $ 0 $ 0 *Prescription copay (30-day supply) $10/$30 $10/$30 THEN THEN Copay (office visits) $20 $20 UNTIL UNTIL Employee Out of Pocket $1,500 $3,000 THEN THEN Coverage 100% 100% Notes: Well-Baby and Preventive Care covered at 100% (not subject to Deductible); *Prescription copay begins on coverage effective date, does not apply to Deductible or Out-of-Pocket Maximum. 7

8 Prescriptions Kaiser HMO Mail-Order Prescriptions (For up to a 100-day supply) Mail-order Pharmacy # Kaiser HMO Most Generic Drugs $10 for up to a 30 day supply $20 for day supply Most Brand Name Drugs $30 for up to a 30 day supply $60 for a day supply Note: Copay applies on coverage effective date; does not apply to Deductible or Out-of-Pocket Maximum 8

9 Medical Coverage PPO/HRA Provider: UnitedHealthcare (UHC) PPO (Preferred Provider Organization) HRA (Health Reimbursement Arrangement) Plan year: January 1 to December 31 Calendar year deductible : January 1 to December 31 Group number = pending (Choice Plus) Member Services = OptumRx Mail Service Pharmacy ( 9

10 How an HRA works with UnitedHealthcare Action Required for Doctor Appointment Reimbursement UnitedHealthcare (UHC) will process your claims and automatically apply your HRA for your deductible (EE $1,500 / Family $3,000) Set up an account on the website No payment is necessary at time of appointment or when picking up a prescription Check the website several days after the appointment for finalized claim * ** Deadline to submit HRA claims is March 31 for the previous calendar year. 10

11 Medical Coverage UHC PPO/HRA Health Reimbursement Arrangement UHC PPO/HRA Employee Only Family Annual Deductible (Calendar Year) Annual Out of Pocket Maximum (Including the Deductibles) $1,500 $3,000* In-Network / Out-of-Network $3,000 / $5,000 In / Out $6,000 / $10,000 SFHS (HRA) (Calendar Year) $1,500 $3,000 Maximum Out of Pocket Exposure to Employee In-Network / Out-of-Network $1,500 / $3,500** In / Out $3,000/$7,000** *Charges Incurred by one or all of the Family members in combination will be used to calculate the Calendar Year Family Coverage Deductible. **After the Maximum Out-of-pocket is reached, Out-of-network services will be covered at 100% of the Maximum Allowed Amount (MAA). The member will be responsible for anything above the MAA. 11

12 Medical Coverage UHC PPO/HRA Health Reimbursement Arrangement Anthem PPO/HRA Employee Only Family Annual Deductible (Calendar Year) $1,500 $3,000 SFHS (HRA) (Calendar Year) $1,500 $3,000 Employee Out of Pocket $ 0 $ 0 Co-insurance (office visits/hospital services) THEN 10% (in-network) / 30% MAA (out) THEN 10% (in-network) / 30% MAA (out) Prescription copay $10/$30/$50 $10/$30/$50 UNTIL UNTIL Employee Out of Pocket $1,500 $3,000 (Total Employee Out of Pocket) ($1,500 In/$3,500 Out)* ($3,000 In/$7,000 Out)* THEN THEN Coverage 100% 100% Note: Well-Baby and Preventive Care covered at 100% in-network (not subject to deductible) *After the Maximum Out-of-pocket is reached, Out-of-network services will be covered at 100% of the Maximum Allowed Amount (MAA). The member will be responsible for anything above the MAA. 12

13 Mail Service Prescriptions UHC PPO Mail Service Prescriptions (For up to a 90-day supply) UHC PPO Tier 1 Tier 2 Tier 3 OptumRx $25 per prescription $75 per prescription $125 per prescription Note: Copay applies only after annual deductible has been met 13

14 Dental Coverage Provider: Direct Dental No network may choose any licensed dentist No deductible Plan year: January 1 to December 31 Maximum benefit $2,000 per individual per calendar year Orthodontic services $1,000 lifetime maximum Child coverage up to age 26 Group number SFH

15 Dental Coverage Dental Coverage Summary Benefits Subscriber Dependents* Type A - Preventive/Diagnostic 100% 100% Services Type B Basic Services 80% 52% Type C Major Services 50% 33% Orthodontics (Adults & Children) 50% Up to lifetime maximum of $1,000 50% Up to lifetime maximum of $1,000 *Dependents covered only if subscriber has medical coverage through Saint Francis High School **Reimbursements are made based upon the 90th percentile of the Regional Usual, Customary and Reasonable fees (UCR). 15

16 Vision Coverage Provider: Superior Vision PPO (Preferred Provider Organization) Plan year: January 1 to December 31 Calendar year deductible : January 1 to December 31 Annual fee: $10 deducted in September Copay: $10/exam & $0 / materials Group number

17 Vision Coverage Vision Coverage Summary Benefits In-Network Out of Network Exam (every 12 months) Ophthalmologist (MD) Optometrist (OD) Lenses (every 12 months) - Single Vision -Bifocal -Trifocal -Lenticular Covered 100% $10 Copay Reimbursed up to $40 Reimbursed up to $30 Covered 100% Frame (every 24 months) Up to $ % discount off additional costs Elective Contact Lenses (every 12 months) Reimbursed up to $35 Reimbursed up to $50 Reimbursed up to $60 Reimbursed up to $95 Reimbursed up to $63 Up to $120 Reimbursed up to $100 17

18 Monthly Premium Contribution Rates Monthly Premium Contribution Rates Pre-tax Monthly Contributions Employee Only EE + 1 EE + 2 or more Medical Kaiser $0 $ $ Medical UHC $30.70 $ $ Dental Direct Dental $0 $0 $0 Vision Superior Vision $0 $7.49 $14.78 Opt Out Medical Credit - $100/month ($1000 maximum) with proof of other insurance coverage. *Note: $10 annual fee for Vision deducted in September 18

19 Flexible Spending Account (FSA) FSA (Flexible Spending Account) Provides a pre-tax way for you to pay for health care expenses not reimbursed by your benefit plans and dependent day care expenses The amount you elect to contribute to an FSA is deducted from your paycheck on a pro-rated basis $500 roll-over option Annual elections are irrevocable unless you have a Qualified Life Event Plan year: July 1 to June 30 Administrator: Pension Dynamics Two types of reimbursement accounts: Health Care Reimbursement Account Covers eligible healthcare expenses not reimbursed by any medical, dental, vision care for you and/or your dependents, e.g. co-pays, deductibles, laser eye surgery, acupuncture, chiropractic care Dependent Day Care Reimbursement Account Covers eligible dependent care (licensed day and elder care) expenses (children under age 13) The annual contribution limits for the FSA are: Maximum $2,550 for Health Care Maximum $5,000 for Dependent Care, or $2,500 if you are married and filing separate tax returns 19

20 Flexible Spending Account (FSA) Claims Submit claims to Pension Dynamics via online submission, , fax or mail Attach itemized bill that includes: name of patient, date of service, provider s name, service provided, condition being treated, amount of expense Attach Explanation of Benefits (EOB) Claim Submission Run-Out Period is 90 days after the end of the Plan Year, (September 30). 20

21 Commuter Benefits (Pre-tax) Administered by Pension Dynamics Employee contributions are done on a pre-tax basis You have until the last day of the month to make your election for the following month No Use it, or lose it provision Plan year: January 1 through December 31st Transportation You can set aside up to $130 per month Good for mass transit expenses ELIGIBLE = BART / Light Rail / Caltrain / vanpools / ferries / bus service INELIGIBLE = Bridge tolls / individual carpools / taxis Parking You can set aside up to $255 per month Parking at or near work Parking at or near public transportation Enrollment 21

22 Qualified Life Event You may be able to change your benefit elections if You have a change in your legal martial status. You have a change in the number of your dependents. You have a change in your employment status. Your spouse or dependent has a change in their employment status. Your dependent has a change in his or her eligibility status. You, your spouse or dependent has a change in residence that affects eligibility for their health plan. You, your spouse or your dependent becomes entitled to Medicare or Medicaid. You must change your benefits elections within 30 days of event. Changes must correlate to Qualified Life Event. 22

23 Sonic Boom Wellness SonicPed state-of-the-art activity monitor stores ALL of your activity uploaded to your private Sonic Boom web site set up daily and long-term physical activity goals Challenge-of-the-Day Daily Summary Much more 23

24 Life Insurance and AD&D Provider: Mutual of Omaha Basic Life insurance and AD&D (Accidental Death and Dismemberment) Coverage is 1 times annual salary, up to a maximum benefit of $200,000 Guarantee Issue amount = $200,000 Benefit reduces by 35% at age 65 Benefit reduces to 50% at age 70 24

25 Short and Long Term Disability STD (Short Term Disability) 7-day Waiting Period Benefit is 66-2/3% of weekly earnings up to $2,100 per week, offset by California State Disability (SDI) STD maximum benefit duration 12 weeks SDI maximum benefit duration 52 weeks LTD (Long Term Disability) 90-day Waiting Period Benefit is 66-2/3% of monthly earnings up to maximum of $9,000 Note: Saint Francis pays 100% of the STD and LTD premiums and the disability benefits you receive under the plan are taxable. 25

26 Employee Assistance Program (EAP) Provider: Mutual of Omaha Up to 3 Counseling sessions per incident for personal or work related issues Immediate help for urgent or crisis calls, 24/7/365 Mutualofomaha.com/eap

27 Emergency Travel Assistance Provider: Mutual of Omaha ID # 9900M U.S Outside U.S. Emergency assistance for you and your family when traveling 100+ miles from home 27

28 Vacation Twelve month employees Years of Completed Service Vacation Accrual Rate in Hours per Pay Period Vacation Accrual Vacation Yearly Accrual Rate Vacation Accrual CAP (1.5 times annual accrual) 0 to 5 years.83 hrs 10 days 15 days 6 to 15 years 1.25 hrs 15 days 22.5 days 16 plus years 1.66 hrs 20 days 30 days Accrued vacation time will be paid upon cessation of employment 28

29 Holidays Labor Day Thanksgiving Day after Thanksgiving Martin Luther King Day Presidents Day Memorial Day Academic Year Employees have one additional paid holiday each year, for a total of seven: Additional Presidents Day Twelve month employees have six additional paid holidays each year, for a total of twelve: July 4 th Christmas (3) New Year s (2) 29

30 Jury Duty On receipt of a jury duty summons, inform the principal or supervisor immediately. It is recommended that faculty attempt to reschedule. Saint Francis will pay for up to 5 days of jury service. If the jury service extends beyond this period the remainder will be unpaid. 30

31 Personal Days Employees who are not eligible for vacation may use up to 2 days of their annual sick leave for personal days for emergency situations only. Personal days can only be granted by the Principal or President. Personal days will NOT be given on in-service days, retreat days, Open House, semester finals, nor days immediately preceding or following scheduled vacations or extended weekends. 31

32 Sick Time 10 sick days per year for academic year employees accrued at 1 day per month during the school year, August through May. 12 sick days per year for twelve month employees accrued at 1 day per month during the calendar year. Maximum accrual is 30 days. Accrued sick time will not be paid upon cessation of employment. 32

33 Workers Compensation If you are hurt on the job, you should: Report the injury to your employer within 24 hours Report the injury to the business office: Elisa Cauchi or Traci Terluin Report the injury to your supervisor/manager If medical treatment is necessary go to: U.S. HealthWorks El Camino Hospital, 2500 Grant Road Mountain View, CA If it is a medical emergency, call

34 403(b) Savings Plan All employees eligible to contribute as of date of hire Employer Contribution for full time employees contributing the minimum salary deferral amount of two percent (2%): tenure 0-10 years 5%; years 6%; 17+ years7% 403b (Pre-tax) and 403b Roth (Post-tax) deferrals Salary deferrals by percentage or dollar 2016 IRS limit $18,000 (age 50 or over may contribute additional catch-up contributions, maximum of $6,000 for 2016) Always 100% vested Two choices: Nationwide (includes minimal mgmt fee), Fidelity Enrollment: submit completed enrollment/beneficiary form to Nationwide/Fidelity Payroll Deductions: After receipt of Welcome Letter submit a salary reduction agreement to Payroll (Traci Terluin) 34

35 Your Paycheck Payday is on the last working day of the month Direct Deposit To view paystubs online, register for ADP ipaystatements: Click on Register Now Pass Code: sfhigh Academic year employees can elect: 10 month pay cycle (Aug-May) 12 month pay cycle (Aug-July) First paycheck is August. 35

36 Benefits Information Websites > Employee Information > Employee Resources and Benefits Or Or > Employee Information > Filice Insurance: Benefits 36

37 Saint Francis High School Benefits 37

38 Filice Insurance Benefits for Saint Francis 38

39 Benefits Questions Elisa Cauchi, Benefits Coordinator X230 Or Eric Pogue, Account Manager, Filice Insurance Or Neha Chopra, Benefits Administrator, Filice Insurance